Transport Partnership
 U.S. ENVIRONMENTAL PROTECTION AGENCY
           Tractor Equipment  Check List
SmartWay Partner:
           Equipment

Base SmartWay Tractor
                                          Company or Organization Name
                                   0 Checklist for SmartWay Tractor
0 Quantity     (Documentation for SmartWay RAM)
                                                       Indicate Manufacturer, Model, Model Year
Must be equipped with the following technology components:
  - Integrated sleeper cab w/ high roof fairing
  - Cab side extenders
  - Integrated sleeper
  - Cab roof fairing
  - Aero mirror
  - Aero bumper
  - Fuel tank faring
  - 2007 or later model year engine
* Note: Indicate only one trailer manufacturer and model per page.  Use mulitiple pages if necessary.

Tractor Steer Tires
(Indicate tire models and quantity)
                                                       Indicate Manufacturer, Model, Model Year
Tractor Drive Tires

(Indicate tire models and quantity)
                                                       Indicate Manufacturer, Model, Model Year
                                                       Indicate Manufacturer, Model, Model Year
                                                       Indicate Manufacturer, Model, Model Year
Select an idling control equipment or strategy:
Idling Control Equipment
(Check applicable option and indicate quantity):

Auxiliary Power Unit or Generator Set      I    I
Fuel Operated Heater
Battery Operated Air Conditioning
  and/or Heating System

Thermal Storage System
Idling Control Strategy (Check applicable option):

Double Drivers                         I    I
Driver Overnight hotel stay

Connects to Electrified Parking Space
  (Truck Stop Electrification)

Tractor aluminum wheels (optional)
                                                       Indicate Manufacturer, Model, Model Year
                                                       Indicate Manufacturer, Model, Model Year
                indicate ivianuTacturer, ivioaei, ivioaei rear
                                                       Indicate Manufacturer, Model, Model Year
                                                       maicate ivianuracturer, ivioaei, ivioaei rear
                Indicate Manufacturer, Model, Model Year
                Indicate Manufacturer, Model, Model Year
                                                       Indicate Manufacturer, Model, Model Year
   U.S. Environmental Protection Agency • EPA-420-F-14-001 • (734) 214-4052 fax • www.epa.gov/smartway

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Transport Partnership
 U.S. ENVIRONMENTAL PROTECTION AGENCY
   SmartWay Partner:
            Trailer Equipment Check  List
              Equipment
"%  Base SmartWay Trailer*
'§.   53 foot, or longer, dry van trailer
                                          Company or Organization Name
                                     0 Checklist for SmartWay Trailer
0 Quantity      (Documentation for SmartWay RAM)
                 Indicate Manufacturer, Model, Model Year
   * Note: Indicate only one trailer manufacturer and model per page. Use mulitiple pages if necessary.
  I Select from the following list of Required Trailer Aerodynamic Configuration Options:
  I Configuration A:                  	
  [Trailer Tires:                        I	I
    (indicate tire models and quantity)
  (Trailer Side Skirt:                    I    I
  [Trailer front-mounted gap reducer:

   Configuration B:
   Trailer Tires:
    (indicate tire models and quantity)
   Trailer Side Skirt:

   Trailer Boat Tail:

   Optional "Total Aero" Configuration:
   Trailer Tires:
    (indicate tire models and quantity)
   Trailer Side Skirt:

   Trailer Boat Tail:

   Trailer front-mounted gap reducer:

  IConfiguation C:
  I Trailer Tires:
    (indicate tire models and quantity)
  I Advanced Trailer End Fairing:

   Configuration D:
  [Trailer Tires:
    (indicate tire models and quantity)
  [Advanced Trailer Skirt:

   Tractor aluminum wheels (optional)
                 Indicate Manufacturer, Model, Model Year
                                                        Indicate Manufacturer, Model, Model Year
                 Indicate Manufacturer, Model, Model Year
                 Indicate Manufacturer, Model, Model Year
                 Indicate Manufacturer, Model, Model Year
                 Indicate Manufacturer, Model, Model Year
                 Indicate Manufacturer, Model, Model Year
                 Indicate Manufacturer, Model, Model Year
                 Indicate Manufacturer, Model, Model Year
                 Indicate Manufacturer, Model, Model Year
                 Indicate Manufacturer, Model, Model Year
                 Indicate Manufacturer, Model, Model Year
                 Indicate Manufacturer, Model, Model Year
                 Indicate Manufacturer, Model, Model Year
                                                        Indicate Manufacturer, Model, Model Year
   U.S. Environmental Protection Agency • EPA-420-F-14-001 • (734) 214-4052 fax • www.epa.gov/smartway

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 Transport Partnership
  U.S. ENVIRONMENTAL PROTECTION AGENCY
        Equipment Check  List
    I confirm that SmartWay Partner,
                                            has:
           number of tractors and/or
COMPANY OR ORGANIZATION NAME

 number of trailers
    outfitted as identified above on the equipment checklist. This SmartWay Partner also commits to
    maintain the SmartWay Tractors and SmartWay Trailers per the manufacturer's
    recommendations or replace them as necessary.

    Permission for EPA SmartWay to publicize that we have SmartWay certified tractors/trailers
    within our fleet is (choose one):
    l_l  granted

    CH  not granted.

    I understand that this information may be provided to companies (mainly shippers) that inquire
    which SmartWay partners have certified trucks and trailers in their fleet. I further understand that
    SmartWay may want to publicize this information on the SmartWay website or in promotional
    materials.
    l_l  By checking this box, I declare that the information submitted via this form is, to the best of
    my knowledge, accurate. I understand that any person who, in the course of negotiating or
    performing under this Agreement, makes, presents or submits a false or misleading statement to
    the government,  or any person who makes a material omission in the course of negotiating or
    performing under this Agreement, may be subject to  liability under all applicable civil and criminal
    statutes including 18U.S.C. '  1001 (criminal liability  for false statements), 31 U.S.C.  ' ' 3801-
    3812 (civil liability for false statements) and 31  U.S.C. ' ' 3729-33 (The False Claims Act).
     Print name:
     Title:
     Date:
U.S. Environmental Protection Agency • EPA-420-F-14-001 • (734) 214-4052 fax • www.epa.gov/smartway

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